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March 15, 2007

Hyperglycemia and DKA

Question from Brighton, Michigan, USA:

My four and a half-year-old son had surgery twice within a 10 day period. I know surgery can cause hyperglycemia. How long would that persist? He complains of feeling "shaky" and has wet the bed every night since the surgery. Random tests on a calibrated home monitor after washing and drying hands have given levels ranging up to 173 mg/dl [9.6 mmol/L]. The lone fasting reading was 95 mg/dl [5.3 mmol/L]. I don't want to subject him to more needless testing if this were normal in a post-surgical period, so I would like to know how long hyperglycemia persists post-op, on average. What should I do, if anything, at this point?

Answer:

Assuming that the child is recovering easily and well, I would expect the hyperglycemia from “surgical stress” to be done by now. On the other hand, you didn’t indicate what the surgery was for and two procedures in 10 days sounds a bit ominous.

PLEASE discuss with your child’s pediatrician as the child may warrant more formal assessment for diabetes and/or be seen by a pediatric endocrinologist.

DS